兔经股动脉插管自体血栓大脑中动脉栓塞模型

Establishment of rabbit model of embolic middle cerebral artery occlusion stroke through selective transfemoral internal carotid catheterization

目的经股动脉途径行选择性颈内动脉插管建立兔大脑中动脉（MCA）血栓栓塞模型,并评价其技术可行性及模型的稳定性。方法新西兰大白兔30只,雌雄不限,平均兔龄14个月,体质量4.1kg。对照组10只,实验组20只。经股动脉途径行选择性颈内动脉数字减影血管造影（DSA）,实验组向颈内动脉内注射1~5枚血栓,对照组仅注射造影剂。行DSA,观察脑血管闭塞情况,用改良Bederson评分法评价神经功能缺损,CT灌注成像观察脑血流灌注,磁共振扩散加权成像（DWI）、2,3,5-三苯基氯化四氮唑（TTC）染色观察脑梗塞情况。结果实验组17只兔（85%）脑缺血模型建立成功,表现为手术侧MCA主干闭塞,神经功能缺损,MCA供血区血流灌注异常,DWI信号、TTC染色异常。3只脑缺血模型建立失败,其中2只为颈内动脉栓塞,1只闭塞的MCA再通。对照组影像学及病理学均无异常。两组CT灌注参数差异有显著统计学意义（P〈0.01）。结论经股动脉途径行选择性颈内动脉插管建立兔MCA血栓栓塞模型具有创伤小、易存活等优点。选择合适的血栓及熟悉兔颈内动脉系统解剖及变异能提高局灶性脑缺血模型的稳定性及可重复性。

Objective To establish rabbit model of embolic middle cerebral artery occlusion stroke with clots through selective transfemoral internal carotid catheterization（ICA）,and evaluate the feasibility and stability of the technique.Methods A total of 30 New Zealand white rabbits were enrolled,either gender,with mean age of 14-month old and mean body weight of 4.1 kg,which were divided into control group（n = 10） and experimental group（n = 20）.Both groups received selective transfemoral ICA and angiography,with 1-5 clots injected in experimental group and only the contrast media injected in control group.Digital subtraction angiography（DSA） was performed to observe cerebral vascular obstruction,the modified Bederson scoring was used to observe neurologic impairment,CT perfusion was performed to observe cerebral blood perfusion,and diffusion weighted imaging（DWI） and 2,3,5-triphenyltetrazolium chloride（TTC） staining were used to observe cerebral infarction.Results Seventeen（85 %） embolic rabbit stroke models in experimental group were successfully established,which manifested occlusion of middle cerebral arteries,neurologic deficits,abnormalities of perfusion,DWI and TTC staining.Three embolic rabbit stroke models were failed,because internal carotid arteries were occluded in 2 rabbits and recanalization occurred in occluded middle cerebral artery in 1 rabbit.No abnormality was observed in control animals.There was obvious difference in CT parameters between 2 groups.Conclusion It is demonstrated that the technique for establishing rabbit models of embolic middle cerebral arteries occlusion stroke with clots through selective transfemoral ICA is simple,micro invasive and reliable.Selection of appropriate clots and familiarity with the anatomy and variation of ICA could obviously improve the stability and reproducibility of focal cerebral ischemia model in rabbits.